This week on Botched continued to get even more exciting as plastic surgeons
Dr. Paul Nassif and Dr. Terry Dubrow came up
against a 29-year-old with “grandma boobs,” a Tijuana tummy tuck, and a
man whose desire to look like Justin Bieber has resulted in over 100
cosmetic procedures.

If for some reason you
didn’t tune into this real life drama, we’re here to recap the highlights from Season 1, Episode 4. Read on for all the scoop, then make sure to watch our exclusive after show (video above) with Dr. Nassif himself!

Charlotte Olhausen

Charlotte Olhausen got her first breast augmentation at the age of 17. “I was really happy with the results,” she explains. “I felt like they were a good size. They were about a C.”

PROBLEM: “Grandma Boobs”
⇼ To fix the sagging that happened after having two kids, Charlotte decided to get a breast implant revision. Unfortunately, she put too much trust in her new doctor, who ended up giving her DDDs without her request. “Within the first couple of days, I started noticing rippling and changing of the shape,” she says. “Now my breasts look like cow udders.” With her sister-in-law’s wedding coming up, Charlotte worries she won’t be able to wear her bridesmaid dress.
CONSULTATION:
Nassif and Dubrow decide to take on the case
⇼ Because of how stretched out her skin has become, Dr. Dubrow warns Charlotte that the smaller they go, the riskier the procedure will be. He says that removing too much skin will lessen the blood supply to nipple and increase the chances of necrosis. (More bluntly put, the nipple with “die” and fall off.
There’s an image for ya.)
⇼ Terry examines Charlotte and discovers that one of her implants is upside down, causing even more strain on the skin. He says that in order to give her the look she wants, they’ll also have to perform a breast lift, resulting in scars all around her areola, up and down the center of her breasts, and all the way from her armpit to the inside of her cleavage.
SURGERY: During the procedure, Terry discovers that Charlotte’s breast muscles are smaller than he expected, which could prove to be a problem post-surgery. “It’s unclear whether her muscles are actually big enough to cover a lot of the implant, and if they’re not, then you’re not going to get rid of all of the rippling,” he explains. Following the implant revision, Terry performs a breast lift to further tighten the sagging skin, removing enough to “cover a football.”POST SURGERY: Charlotte seems to be in a great deal of pain at her one-day check-in, but she’s worrying the most about the state of her nipples. Dr. Dubrow has good news, though: Not only are her nipples alive and well, but he promises her that she’ll be able to make a full recovery in time for her sister’s wedding.
OUTCOME:
The big day have finally arrived and Charlotte’s ready to show off her results in a sexy, strapless bridesmaid dress. “Charlotte’s really happy and I think this is going to boost her confidence,” says her husband. “Charlotte looks perfect.”

Toby Sheldon

German-born Toby Sheldon has grabbed headlines around the globe for spending over $100,000 to look like Justin Bieber. The 33-year-old songwriter has undergone roughly 20 plastic surgeries, not to mention years of injectables and fillers. “The first surgery was a marathon,” he reveals. “We did the cheeks, the temples, lifting the lips, cutting the chin, doing the liposuction, the fat injections. When I came home, my girlfriend was like, ‘What the hell did you do?!’ My girlfriend doesn’t really like Justin.”
MORE:
Who Is Justin Bieber Lookalike Toby Sheldon?
PROBLEM:
Forehead and Jaw Reductions
⇼ “The only way I’ll ever stop looking like Justin Bieber is when I die,” Toby says. He believes (Beliebs?) he still has more work to do before he really looks like The Biebs, and decides that the next best step is to get reductions on his forehead and jaw.
CONSULTATION:
Nassif and Dubrow decide to pass on the case
⇼ Nassif and Dubrow tell Toby that the only way to shorten his forehead would be to insert a tissue expander, which essentially means he’d be carrying a large balloon around in his head. Terry tells Toby there’s a significant chance of losing blood supply to his scalp and losing all of his hair.
⇼ The biggest concern for the doctors is the reduction of Toby’s jaw. “The problem with that is there are main branches of the facial nerve there that control lip movement,” Terry explains. “If that goes wrong, then [your mouth won’t function normally], and there’s no going back.” For the sake of safety, the doctors decide to pass on the case.

Desiree White

Desiree White decided it was time to get a tummy tuck after giving birth to her children. Her mom told her about a doctor in Tijuana that two of her friends had recommended — a doctor that was asking a significantly lower price than those in the United States. She decided to make the trip in an effort to save money, but the experience quickly turned into a real-life nightmare.
MORE:
Why I Chose to Do My Surgery in the States
PROBLEM:
Tijuana Tummy Tuck and Vagina on Her Stomach
⇼ Instead of giving Desiree anesthesia to numb the pain and put her to sleep, the doctor applied sheets of ice to her stomach then operated on her while she was fully awake. “[The doctor] made the vagina part of skin come up further in order to sew it together,” she explains. “When I look at my stomach, I see deformity.”
CONSULTATION:
Nassif and Dubrow decide to take on the case
⇼ Nassif and Dubrow discuss the case before Desiree arrives. “I’ve been doing plastic surgery for over 23 years,” says Terry. “I’ve reconstructed every major problem you can see. But I’ve never seen this before. As far as the things that can go wrong with a tummy tuck, Desiree had every one of those things occur.”
⇼ The doctors are shocked when Desiree explains what happened with the ice. “You’re
kidding me!” Terry exclaims. “The problem with using ice as an anesthetic agent is that it kills the tissue before you operate. So the doctor was essentially operating through dead skin, which just won’t heal properly.” Terry worries the tissue is so damaged that Desiree’s stomach might be unfixable. That said, the two decide to take the risk together and literally cross their fingers for the best.
SURGERY: Desiree arrives with her mom, who wastes no time grilling Dr. Dubrow on his background and experience. He assures them he knows what he’s doing, which is apparent during the surgery. After performing liposuction on her lower back and sides, he begins working on her stomach. In order to bring the scar back below the bikini line, he tightens the abdominal wall and pulls the skin down with less tension.
POST SURGERY:
Desiree’s ready to be done with the healing process, but mostly, she’s ready to be done with the constipation caused by her pain pills. “If I could poop, I’d be so happy right now!” she says. “It would be like giving me a Christmas present!” On the plus side, Desiree seems to be healing nicely and her scar is far below the bikini line. “My coochie has returned to its rightful spot!” she exclaims.

OUTCOME:
Six weeks after the surgery, Desiree’s ready to make the big reveal to her mom. She shows up in a crop top and low-rise jeans, flaunting a flat tummy and no visible scar. “Certain things I didn’t want to do before, I can do now!” she says. “This has totally raised my confidence. As long as you’re confident, people gravitate to you.”

RealSelf Highlight of the Week:

Episode 4 brought plenty of amazing moments, but one in particular really made us laugh. While examining Toby’s face, the doctors shared this exchange:

TOBY: What you guys are telling me is “no, no, no.” So, you’re not Beliebers?